Medicina Fluminensis, Vol. 62 No. 3, 2026.
Case report, case study
https://doi.org/10.21860/medflum2026_349237
Plasma Cell Granuloma of the Conjunctiva: A Case Report
Martina Murković
; University Hospital Centre Rijeka, Clinical Department of Pathology and Cytology, Rijeka, Croatia
*
Maja Mrak
; University Hospital Centre Rijeka, Department of Ophthalmology, Rijeka, Croatia
Damir Vukušić
; University Hospital Centre Rijeka, Department of Ophthalmology, Rijeka, Croatia
Andrea Lukanović Kegalj
; University Hospital Centre Rijeka, Department of Ophthalmology, Rijeka, Croatia
Tea Čaljkušić-Mance
; University Hospital Centre Rijeka, Department of Ophthalmology, Rijeka, Croatia
Andrea Dekanić
; University Hospital Centre Rijeka, Clinical Department of Pathology and Cytology, Rijeka, Croatia
* Corresponding author.
Abstract
Aim: To present a rare case of conjunctival plasma cell granuloma (PCG) and emphasize the diagnostic challenges in differentiating it from inflammatory myofibroblastic tumour (IMT) and plasmacytoma, particularly in the context of potential IgG4-related disease. Case report: A 49-year-old female presented with a five-month history of a progressively enlarging lesion on the left conjunctiva. MRI (Magnetic resonance imaging) and PET/CT (Positron emission tomography/Computed tomography) revealed a conjunctival mass with concurrent enlargement of the left lacrimal gland. Surgical excision was performed, and histopathological examination showed a dense plasma cell-rich infiltrate with approximately 60 IgG4-positive plasma cells per high-power field, a polyclonal kappa/lambda pattern, and negative ALK expression, consistent with plasma cell granuloma. Serum IgG4 levels were within normal limits, and no monoclonal component was detected on immunofixation, excluding multiple myeloma and systemic IgG4-related disease. The patient was treated postoperatively with topical corticosteroids, without indication for systemic therapy. Conclusion: Conjunctival PCG is an exceptionally rare entity that may clinically and histologically resemble neoplastic conditions. Thorough histopathological evaluation with immunohistochemistry is crucial for accurate diagnosis. The recognition of this lesion is important to avoid overtreatment and misclassification, particularly in the context of plasmacytoma and IMTs. Further research is needed to better understand its aetiology, pathogenesis, and optimal management.
Keywords
conjunctiva; igg4; ophthalmology; plasma cell granuloma; plasmacytoma
Hrčak ID:
349237
URI
Publication date:
1.9.2026.
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